Loss of Consciousness

Neurologists are commonly referred patients with loss of consciousness, where there is a suspicion of the possibility of epileptic seizure. Since a seizure carries important implications for safety, and driving, getting the right diagnosis in a timely way is key.

Statistically, around 9 in 10 episodes of loss of consciousness are due to reductions in blood flow to the brain (termed “syncope”). In principle, separating these from epileptic seizures should be straightforward. In most patients this is indeed very clear, but in a significant minority, the occurrence of jerks (which occur in both faints and seizures) and the characteristics of recovery means care is needed to arrive at the right conclusions.

In almost all circumstances, noting how common faints are and how a minority are related to undiagnosed heart conditions, an electrocardiogram (ECG) should be done and the results available prior to seeing a neurologist.

A successful neurology consultation for a blackout is best done:

• soon after the event (so memories are fresh); and
• with a witness account available (either in person, by telephone/video, or in the form of a clear and contemporaneous written account).

A timely private neurology opinion can therefore be helpful to arrive at a diagnosis while the relevant information is still at the forefront of memory.

A neurologist helps navigate complexity in the history to arrive at a clear and definitive opinion. This allows patients to move confidently forward with their future with regard to matters like safety, driving, travel and insurance. Indeed, in my experience, most patients presenting with loss of consciousness receive a clear diagnosis at the end of the first consultation. Where uncertainty remains, additional tests may be recommended - commonly a head scan (MRI) and a brain wave trace (electroencephalogram, EEG).